MAGNETIC RESONANCE IMAGING- Is the integration of the minute magnetic properties of the And because it does not use
d because it does not use Ionizing radiation, MRI is risk-free since it examine only through
tissue atoms with the static magnetic field, to be in a resonant state with an applied external Radio-
frequency pulse, and will in turn produce an MR signal that is converted into an exquisite tissue
image.
 It is the process by which certain nuclei, when placed in a magnetic field can absorb and
release energy in the form of radio waves.
 MRI is a medical diagnostic technique that creates images of the body using the principles of
“Nuclear Magnetic Resonance”.
 The word “Nuclear” has been disassociated from MRI because of public apprehension about
Nuclear energy and Nuclear weapons.
 MRI is a versatile, powerful and sensitive tool that can generate thin section images of any
part of the body -including the heart, arteries and veins from any angle and direction in the
body.
 MRI is possible in the human body because the body is filled with small biological magnets.
The most abundant and responsive of which is the “Proton”- the nucleus of the “Hydrogen”.
Once the Patient is Place in the Cylindrical Magnet, the Diagnostic Process Follows Three (3) Basic
Steps:
1. First, MRI creates a steady state within the body by placing the body in a steady magnetic field
that is 30,000 times stronger than the earth’s magnetic field.
2. Then MRI stimulates the body with radio waves and “listens” to the body’s electromagnetic
transmission at a selected frequency.
3. The transmitted signal is used to construct internal images of the body using the principles similar
to those developed for CT scanners.
 In the current medical practice, MRI is preferred for diagnosing most diseases of the Brain
and Central Nervous System. It provides equivalent anatomical resolution and superior
contrast resolution to that of CT scan. So, the physical principles of MR image production are
totally different from CT and Conventional radiography.
 MRI also produces functional information similar to that of “Positron Emission Tomography”
(PET) scanners, but with superior anatomical detail. Although an MRI scan is relatively
expensive, it may actually reduce cost to patient’s and hospital by providing diagnostic
evaluation to out-patients and thereby frequently limiting more expensive hospitalization.
the interactions of magnetism and radiowaves with tissue to obtain an image, except for
patients with “Cardiac Pacemakers”, patient who might have an iron filings next to their
eyes, patients with Inner Ear transplants and patients with Aneurysmal clips in their brain.
SIGNIFICANT ADVANTAGES OF MRI OVER OTHER DIAGNOSTIC MODALITIES:
1. Best Low Contrast Resolution
2. No Ionizing Radiation
3. Direct Multi-Planar Imaging
4. No Bone or Air Artifacts
5. Direct Flow Measurements
6. Totally Non-Invasive
7. Contrast Media not required.
Principles of Magnetic Resonance Imaging:
 Magnetic Resonance Imaging is founded on the principles of “Nuclear Magnetic Resonance
(NMR). NMR has been an important branch of Physics and Chemistry since 1940’s when it
was discovered independently by Bloch and Purcell.
 Initially, a tool used by chemist to better understand the properties of materials, NMR came
to be thought of as having applications for biological systems as early as 1971. Over the time
since then, techniques have evolved to the point at which NMR has become indispensable in
the diagnosis of disease. The most abundant element in the human body in the “Hydrogen”
which is composed of a single proton that possesses magnetic properties.
 Once the patient is placed in an ordinary couch, the hydrogen nuclei are pointed anywhere.
But if the patient is placed in a magnetic couch, the hydrogen nuclei will tend to aligned
because of the extended magnetic field which then causes to become excited. Excited
means, that the hydrogen nuclei has an excess energy that would be released in a form of
radiowaves or we call it as the “Free-Induction Decay (FID)”, which is the signal coming from
the patient. This Free-Induction Decay will now be received by the antenna that is
connected to the machine and is then interpreted by the computer.
 COMPARISON OF MR TO CONVENTIONAL RADIOGRAPHY:
 Since MR provides sectional images; it serves as a useful adjunct to conventional x-ray
techniques.
 With radiograph, all body structures exposed by the x-ray beam are superimposed into one
“flat” image. That is why multiple projections or contrast agents are required to clearly
distinguish one anatomic structure or organ from another.
 However, sectional imaging techniques such as Ultrasound, Computed Tomography and
Magnetic Resonance Imaging more easily separate the various organs because there is no
superimposition of structures.
 In addition to problems with overlapping shadows, conventional radiography is relatively
limited in its ability to distinguish types of tissues. Also in radiographic techniques, contrast,
the ability to discriminate two different substances depends on differences in x-ray
attenuation within the object, and the ability of the recording medium (ex. film) to detect
these differences.
 Radiographs cannot detect small attenuation changes. In general, conventional radiographs
can distinguish only air, fat, soft tissue, bone and metal where the difference in attenuation
between each group is large. Most organs, for example, liver and kidneys cannot be
separated by differences in x-ray attenuation alone unless the differences are magnified
through the use of contrast agents.
 MR can also resolve relatively small contrast differences among tissues. It should again be
emphasized that these tissue differences are independent from the differences in x-ray
attenuation.
HISTORICAL DEVELOPMENT
 It was Democritus, a Greek Philosopher who was the first to theorize that all matter consists
of both invisible and indivisible particles, which he named it “atoms” from the Greek word
“Atomos” – meaning “uncut”.
 It was also the early Greeks who first became mystified how certain objects would be
attracted or repelled by invisible forces that we know as “static electricity”. Concurrently, in
the city of Magnesia in Asia Minor (Turkey), the mysteries of mass further perplexed
humans when they observe that when certain rock formations were spun on their axes, they
always and immediately returned to their original orientation.
 These magnetized structures, which are called Lodestones, were used for navigational,
religious and magical purposes.
 The city of Magnesia is the origin of the term “Magnetism”. The heart of MRI mathematics
that we now use to translate raw MR signals into Spatial location first emerged when the
brilliant Jean-Baptiste-Joseph Fourier first introduced this very complex mathematical
process over 200 years ago while serving Emperor Napoleon of France.
 Our early ancestors (BC) were the first to theorize that there was a relationship between
electricity (electron flow) and magnetism (properties of lodestone). However, its relationship
remained unsolved until approximately 2000 years later.
 IN 1819, Hans Christian Oersted accidentally discovered that electricity produces magnetism
when he noted that a compass needle would deflect in the presence of an electric charge.
 Twelve years later, Michael Faraday stated and successfully proved that since Electricity can
produce magnetism, why not the reciprocal? Why can’t magnetism produce electricity? This
revelation gave rise to Faraday’s law of magnetic induction, which is not only the basis of
MR signal detection but also is the precursor to modern-day electro mechanics.
 Faraday discovered that magnetic fields traversed through an electrical coil at a 90 degree
angle would induce a voltage/current in that coil. He further noted that in order for
magnetic induction to be sustained the magnetic field had to be interrupted or pulsed. For
this contribution, and many others, Michael Faraday is regarded by many as the “Father of
Electricity”.
 The scene was set for Wilhelm Conrad Roentgen to discover high frequency Electromagnetic
x-ray in November 8, 1895 and Frederick Joliot and Marie Curie the Gamma ray in 1896.
Their discoveries soon demonstrated that high frequency wave energies were identifiable,
detectable, measurable and often biologically damaging.
 There are many physicists/scientists who collectively set the stage for Magnetic
Resonance Imaging (MRI). The most significant are as follows:
1911 - Ernest Rutherford: recognized the Nucleus.
1911- J.J. Thompson : Objective proof of electron’s existence.
1913 – Neil's Bohr : Defined the electron geometric patterns and properties; opened door to
quantum physics.
- Otto Stern : established method to measure a Magnetic Dipole Moment (DMD).
- Wolfgang Pauli : Coined the phrase Nuclear Magnetic Resonance.
- Isidor Isaac Rabi : devised and performed the first Nuclear Magnetic experiment.
The basic principle of MRI is that certain atomic nuclei, if placed in a magnetic field can be
stimulated by (absorb energy from) radiowaves of the correct frequency.
Following this stimulation, the nuclei release the extra absorbed energy by transmitting
radiowaves (MR signal), which can be receive by an Antenna and analyzed.
Relaxation time represent measurement of the rates of this energy release. These
properties of Magnetic Resonance were first discovered in the 1940’s by separate research
groups headed by Felix Bloch and Edward Purcell. Their work led to the use of MR
Spectroscopy (an instrument that produces spectra especially of visible electromagnetic
radiation) for the analysis of complex molecular structure and dynamic chemical processes.
In 1946, two American Theoretical Physicist Felix Bloch and Edward Purcell continued to
explore the mystery of the atom. While working independently, they noted that when a
test-tube sample of a pure substance was magnetically energized and radio-frequency
bombarded the excited atoms themselves would respond by singing their own atomic
“tune”. These tune signals were detected and recorded into Spectroscopic image
corresponding to their frequency values.
Virtually, overnight Nuclear Magnetic Resonance, the prelude to Magnetic
Resonance Imaging (MRI) was about to be born. Both Bloch and Purcell were the recipients
of the Nobel Prize in 1952 for their major contribution in uniquely discovering and
implementing the use of atomic energy for analytical purposes.
The world of medical imaging was irrevocably altered when in 1970 a Visionary American
Physician/Physicist, Dr. Raymond Damadian exclaimed to some of his close co-workers that
he was going to build a scanner for whole body human imaging. Dr. Damadian suddenly was
struck with the idea while performing Nuclear Magnetic Resonance experiments on rats that
he had surgically implanted with malignant cells. He readily observed that the rat tumor
tissues would respond to magnetic excitation and, when bombarded by a resonant pulse,
would emit two different types of signals as the torqued magnetic dipole moments relaxed
to equilibrium. These signals would vary in their image contrast characteristics
corresponding to whether the tissue was healthy or diseased.
It was Felix Bloch who named these two relaxation rates T1 & T2, many years prior to
Damadian’s discovery.
Dr. Damadian also discovered in the early 1970’s that the structure of water is the very
essence of MR imaging.
The primary reason is that, each water molecule contains a very intense magnetic
(north/south) dipole because its hydrogen’s orbiting/spinning electrons spend more time
orbiting around the bonded oxygen that they spend orbiting the hydrogen.
This condition creates an intense regional source of MR signals which Damadian
subsequently proved to be detectable and recordable as a characteristic image.
Dr. Damadian and his team spend the next seven years designing and building the very first
MRI Whole Body Scanner for whole body human imaging.
On July 3, 1977, they performed the first whole body Trans-axial Proton density weighted
slice image requiring 4 hours and 45 minutes.
In 1973, Paul Lauterbur published the first cross-sectional images of objects obtained with
MR techniques.
These first images were crude (unrefined petroleum) and only large objects could
be distinguished. Since then, there has been an explosion in MR technology so that currently
very small structures can be imaged rapidly and the resolution of MR images is approaching
that of Computed Tomography.
 1967 – Jasper Jackson produced the first MR signal from a live animal.
 1972 – Paul Lauterbur and Raymond Damadian produced the first Magnetic Resonance
image.
 1975 – Damadian produced the first live animal MR images.
 1977 – first diagnostic human images has been obtained.
 Relevant Nomenclatures (Terms & Quantities in MRI)
 Free-Induction Decay (FID) – is the signal emitted by tissue after an “RF Pulse” has excited
the nuclear spins of that tissue at resonance.
 Gradient Magnetic Field – a change in the intensity of a magnetic field in space. If the
change is smooth and proportional, it is called a “Linear Gradient” magnetic field.
 Gyromagnetic Ratio – is a constant, specific ratio for each nucleus; relating the
precessional frequency in a magnetic field.
 Larmor Frequency – is the frequency at which a nucleus precesses in a magnetic field
dependent on the strength of the applied magnet.
 Magnetic Moment – a force created when a Magnetic Dipole (magnetic poles having
equal magnitude but of opposite sign or polarity) is in a magnetic field.
 Magnetization – is the large scale macroscopic magnetic moment resulting from many
nuclear magnetic moments.
 Precession – is the wobble of the rotational axis of a spinning body about a stationary axis
that describes a cone.
 Radiofrequency (RF) – an electromagnetic radiation having a frequency from 0.3KHz to
300GHz.
 MRI employs RF in the range of approximately 1-100 MHz.
 1 Hertz – 1 cycle or oscillation per second
 KHz - thousands of cycles per second
 MHz - millions of cycles per second
 GHz - bollions of cycles per second
 Resonance – is the transfer of vibrating energy from one system to another.
 Specific Absorption Rate (SAR) – is the power absorbed by tissue during RF irradiation.
 Spin Density (SD) – is a measure of the concentration of nuclei contributing to the MR
signal by release of energy following resonance.
- is the concentration of nuclei in tissue precessing at the Larmor Frequency and
contributing to MRI signal.
 T1 Relaxation Time – is the time required for the interactions between “nuclear spins”
and the “tissue lattice” to return to normal following RF excitation.
- is also called “Spin-Lattice” or “Longitudinal Relaxation Time”.
 T2 Relaxation Time – is the time required for the interaction between “nuclear spins” and
“adjacent nuclear spins” to return to normal following RF excitation.
- is also called “Spin-Spin” or “Transverse Relaxation Time”.
 Tesla (T) – is the system international (SI) unit of magnetic field strength. The classic unit
is Gauss.
o 1 Tesla = 10,000 Gauss or 10 Kilogauss.
 The Earth’s Magnetic field approximates 0.5 Gauss.
 Antenna – a device for transmitting or receiving radiowaves.
 Attenuation – is the reduction or weakening in energy or amount of beam of radiation as
it passes through tissues or other substances.
 Cryogenic – relating to extremely low temperature.
- Freezing at or near absolute zero.
-Both liquid Helium and Nitrogen is generally used in MRI to optimize superconductivity.
 Frequency – is the number of times that a process repeats itself in a given periodof time.
 Fringe Field – portion of the magnetic field extending away from the confines of the
magnet that cannot be used for imaging, instead can affect nearby equipment or personnel.
 Gating – organizing the data so that the information used to construct the image comes
from the same point the cycle of a repeating motion, such as heartbeat.
 Gauss – is a unit of magnetic field strength.
 Noise – is the random contribution to the total signal that arise from stray external
radiowaves, imperfect electronic apparatus, etc.
-Noise cannot be eliminated but it can be minimized. Likewise, noise tends to degrade the
image by interfering with accurate measurement of the true MR signal.
 Nucleus (plural-nuclei) – is the central point of an atom composed of protons and
neutrons.
 Paramagnetic – referring to materials that alter the magnetic field of nearby nuclei.
-Paramagnetic substances are not themselves directly imaged by MR, but instead change
the signal intensity of the tissue where they localize, thus acting as MR contrast agents.
-Paramagnetic agents shorten both T1 and T2 of the tissues they affect, actions which tend
to have opposing effects on signal intensity.
 Permanent Magnet – an object that produces a magnetic field without requiring an
external electricity supply.
 Proton Density – is a measure of proton concentration.
 Pulse – a short burst of radiowaves. If the radiowaves are of the appropriate frequency,
they can give energy to nuclei that are within a magnetic field by the process of “Magnetic
Resonance”.
 Pulse Sequence – is a series of radiowave pulses designed to excite nuclei in such a way
that their energy release has varying contribution from Proton Density, T1 or T2 processes.
 Raw Data – is the information obtained by radio reception of the MR signal as stored by a
computer.
 Relaxation – is the return of excited nuclei to their normal unexcited state by the release
of energy.
 Relaxation Time – represents a measurement of the rates of energy release in Magnetic
Resonance.
- it is a measure of the rate at which nuclei after stimulation, release their extra energy.
 Resistive Magnet – a simple electromagnet in which electricity passing through coils of
wire produces a magnetic field.
 Signal in MR – is the radiowave that is transmitted by nuclei on relaxation.
 Spin-Lattice Relaxation – is one of the major determinants of MR signal strength which is
the release of energy by excited nuclei to their general environment.
-T1 is the rate constant measuring Spin-Lattice Relaxation.
 Spin-Spin Relaxation – one of the major determinants of MR signal strength which is the
release of energy by excited nuclei by interaction among themselves.
-T2 is the rate constant measuring Spin-Spin Relaxation.
 Superconductive Magnet – an electromagnet in which the coils of wire are cooled to
extremely low temperature so that the resistance to the conduction of electricity is nearly
eliminated.
 Spectroscopy – science of analysing the components of an electromagnetic wave usually
after its interaction with some substances.
 Slice – a cross-sectional image.
- a thin section of the body from which data is acquired to produce the image.
 Resonance – the process of energy absorption by an object that is tuned to absorb energy
of a specific frequency only.
  2DFT – Two Dimensional Fourier Transform
 Angular Momentum – is the angle formed between a precessing object and its imaginary  B - Magnetic Field
axis.  B1 - RF Torqueing Pulse
 Bo – Static Magnetic Field
 Axis – an imaginary line that passes through the center of the body of mass or field of  CNR – Contrast-to-Noise Ratio
force.  FT – Fourier Transform
 y - Angular Momentum
-In MRI, the conventional: X = sagittal Y = coronal Z = trans-axial  ADC – Analog-to-Digital Converter
 BW – Bandwidth
 Solenoid – a helix (coil) with electricity flowing through the conductor  DTPA – Diethylenetriamine Penta acetic acid
-Solenoid can be identified by its North and South Pole.  SAR – Specific Absorption Rate
-The Greek word Solenoid means “channelled”  RF – Radiofrequency
 NEX – Number of Excitation
-Aliasing – is an artificial wraparound image that extends beyond the image proper caused  SE – Spin Echo
by misregistration of the higher frequency component being posted at the lower frequency  T - Tesla
areas.  T1 – Longitudinal Relaxation Time, MR signal
 T2 – Transverse Relaxation Time, MR signal
 Voxel – a 3D volumetric portion of an image where viewing face is the pixel and whose  TE – Echo Time
depth is the third dimension.  TI - Inversion Time
 TR – Repetition Time
 Velocity – speed in a particular direction.
 FOV – Field of View
 M - Magnetization
 Viscosity – a property of a fluid or semi-fluid that affects its mobility.
 Mo – Magnetic Dipole Moment
 Mxy – Magnetic Dipole Moments in the transverse x-y plane.
 Spatial Resolution – is the ability to define minute adjacent objects/points in an image
and is generally measured in lines pairs/mm (lp/mm)

 Spectrometer – is a computer-controlled part of an MR system which generate the MR

phenomenon.

 Spin – is the intrinsic angular momentum behavioral pattern that create the precessing
MDM’s (magnetic dipole moments)

SYMBOLS:
PROTON PRECESSION and RESONANCE
Precession – is the phenomenon of magnetic field or any object spinning or gyrating around
an imaginary axis of its own creation.
-It is the wobble (rotation) of the rotational axis of a spinning body about a stationary axis
that describes a cone.
-The principles of NMR are based on the fact that the nuclei of certain elements have a
magnetic moment.
-This means that if a sample of atoms of one of these elements were placed in a magnetic
field, its nuclei would tend to line up with the field.
-The nuclei don’t actually line up exactly in the direction of the magnetic field, however. The
laws of quantum mechanics dictate that they align at an angle to the direction of the field.
Each type of nucleus has a quality known as angular momentum associated with it. The idea
of an intrinsic angular momentum of the nucleus is fundamental to MRI.
It can be compared to the example of a spinning top. When a top is spun (past
part of spin) at an angle to the vertical, it will precess about the vertical axis. That is,
the top will rotate its own axis, and the axis of the top’s rotation will revolve about the
vertical axis.
This precession is due to the angular momentum of the top, which is in turn due
to the spinning of the top.
In the same way, a nucleus that is aligned at an angle to the direction of the
magnetic field will precess about the axis of the field.
The analogy is so exact that the nuclei are commonly referred to as spins that
are manipulated to generate images.
In quantum mechanics, the angular momentum is represented by a number called
the spin of the nucleus.
Depending on the value of the spin number of a particular nucleus, there will be
several different orientations in which the nuclei may line up in a magnetic field.
Each orientation is represented by a different angle from the direction of the
magnetic field about which the nucleus will precess.
The frequency at which the nucleus precesses is a function of both the strength
of the magnetic field and the particular nucleus.
This frequency called the Larmor Frequency, is equal to the product of the
strength of the magnetic field and a constant called the Gyromagnetic Ratio.
The gyromagnetic ratio is unique for each nucleus that has a magnetic moment.
The Larmor Frequency is important because it is the frequency at which the nucleus
will absorb energy that will cause it to change its alignment.
MAGNETIC SIGNAL PRODUCTION:
The structure of the atom can be compared with the solar system, - with the sun
representing the central atomic “nucleus”.
The planet orbiting the sun represent the “electrons” circling around the
nucleus.
MR imaging depends on the properties of the Nucleus.
Many, but not all, atomic nuclei have magnetic properties, that is, they act like
tiny bar magnets.
Normally, the magnetic nuclei point in random directions, however, if these
nuclei are placed in a strong, uniform magnetic field, they attempt to line up with the
direction of the magnetic field.
The word “attempt” is appropriate because the nuclei do not line up precisely
with the external filed but an angle to the field, and they rotate about the direction of
the magnetic field similar to the wobbling of a spinning top.
The wobbling motion is called Precession and occur at a specific frequency (rate)
for a given atom’s nucleus in a magnetic field of a specific strength.
These precessing nuclei can absorb energy if they are exposed to pulses of radiowaves,
provided the radiowaves are of the same frequency as the frequency of the nuclear
precession.
This absorption of energy occurs through the process of Resonance.
After the external radiowaves is turned off, the excited nuclei relax; They
release their excess absorbed energy in the form of radiowaves. This radiowaves
transmitted by the nuclei represents the MR signal and is not pulsed.
The MR signal can be picked up by a sensitive antenna, amplified and process by a
computer to produce a sectional image of the body.
This image, like image produced by a CT scanner, represents an electronic image
that can be viewed on a television monitor and adjusted to produce the most
information.
If desired, the image can be photographed for further study.
Most MR image currently involves the element hydrogen, the nucleus of which is
a single proton.
Hydrogen nuclei are the strongest nuclear magnets on a per-nucleus basis (thus giving
the strongest MR radio signal).
Also, hydrogen is the most common element in the body (again giving the
strongest signal).
Strong signal are important to produce a satisfactory images. Nevertheless, many
other nuclei in the body are potential candidates for imaging.
Such nuclei as Phosphorus and Sodium may give more useful or diagnostic
information than hydrogen, particularly in efforts to understand the metabolism of
normal and abnormal tissues.
Changes in metabolism may prove to be more sensitive and specific in the
detection of abnormalities than the more physical and structural changes recognized
by hydrogen imaging MR or by CT.
MR SIGNAL SIGNIFICANCE
Conventional radiographic techniques including CT, produce images based on a
single property of tissue: x-ray attenuation or density.
MR images are more complex because they contain information about Three Properties
of Matter: 1. Nuclear Density 2. Relaxation Rates 3. Flow Phenomena
• Each contributes to over-all MR signal strength.
The computer processing convert signal strength to a shade of gray on the image.
Strong signal are represented as white in the image and weak signal are black.
One determinant of signal strength is the number of precessing nuclei (spin
density) in a given volume of tissue.
The signal released by the excited nuclei is proportional to the number of nuclei
present.
Therefore, signal strength depends on the nuclear concentration or density.
Since the nucleus of hydrogen is a single proton, this is often referred to as
proton density.
Most soft tissues, including fate have similar number of protons per unit volume,
so that proton density poorly separate most tissues.
However, some tissues have very few hydrogen nuclei per unit of volume;
example includes the cortex of the bone and air in the lungs.
These have very weak signals as a result of low proton density and can be easily
distinguished from other tissues.
MR signal intensity also depends on the Relaxation Time of the nuclei.
` The process of energy release by the excited nuclei is called relaxation, and this
occur at different rates in different tissues.
There are two processes by which excited nuclei relax:
o When the nuclei released their excited energy to the general
environment (or lattice – the arrangement of atoms in a substance), this
is called the Spin-Lattice Relaxation and the rate of this relaxation
process is called T1.
o Spin-Spin Relaxation is the release of energy by the excited nuclei through
interaction among themselves and the rate of this process is measured by
T2.
The rates of relaxation (T1 & T2) of a hydrogen nucleus depend on the chemical
environment in which that nucleus is located.
Chemical environment differs among tissues. For example, the chemical environment
of a hydrogen nucleus in the spleen differs from that of a hydrogen nucleus in the liver.
The relaxation rates of these nuclei differ, and the MRI signals given off by these
nuclei differ.
Liver and Spleen have a different signal intensity and different appearance on
the image, enabling the viewer to discriminate between them. Similarly, fat can be
separated from muscle and many tissues can be distinguished from others, based on the
rate of relaxation of their nuclei.
The most important factor in tissue discrimination is the “relaxation time”.
The signals produced by MR imaging techniques contain a combination of Proton
Density, T1 & T2 information.
By stimulating the nuclei with certain specific radiowave pulse sequences, the
radio signal that the nuclei release may have more information about proton density,
or about T1, or about T2.
Therefore, one can obtain images weighted towards any one of these three (3)
parameters.
In most imaging schemes, a short T1 gives a high MR signals in T1 weighted
images.
Conversely, along T2 gives a high signals in T2 weighted images.
Using data from two or more regular images, computer calculation of pure proton
density, T1 or T2 images can be made.
However, these calculated images have more noise and less resolution than
regular MR images.
The final property that influence image appearance is Flow.
Moving substances, for complex physical reasons usually have weak signals.
Flowing blood in vessels have a low signals, easily discriminated from surrounding
stationary tissues without need for contrast agents required by regular radiographic
techniques.
Stagnant blood (such as an acute blood clot) typically has high MR signals in most
imaging schemes, as a result of this short T1 and long T2.
It may be possible to assess vessels patency or determine the rate of blood flow
through vessels by employing this property of MR.
MAGNETIC RESONANCE IMAGES
Magnetic Resonance Imaging has many characteristics in common with other
imaging modalities.
Such characteristics are; Spatial Resolution, Low Contrast Resolution and Noise.
SPATIAL RESOLUTION
At present, the Spatial Resolution of MRI is equal to that of Computed
Tomography.
When imaging high-contrast objects, structures less than 1mm can be visualized
routinely.
Still higher spatial resolution can be obtained by reducing slice thickness or by
increasing the amount of data collected.
To increase data collection, one must increase MRI signal acquisition, but this
may require an unacceptably long examination time.
Another way to improve spatial resolution is by raising the MR signal strength.
Signal increases with the magnetic field strength. However, there are practical
limitations to how strong the magnet can be used for MRI.
Higher magnetic fields require more intense and higher-frequency RF pulses
which are often an unacceptable solution.
CONTRAST RESOLUTION
One of the fundamental advantages of MRI is its potential for resolution of lowcontrast
structures.
A determining factor in the contrast between two tissues in a radiographic image is the
difference in their x-ray attenuation coefficient.
For most tissues, these differences amount to less than 1%.
In conventional radiographic image, this 1% contrast is degraded by scatter
radiation.
In CT, scatter radiation is largely rejected so that 0.5% contrast can be imaged.
The difference in the MRI Parameters among biologic tissues is frequently 30% or
more.
We must remember that any MR image is a mixture of all three NMR parameters:
Spin Density (SD), T1 and T2.
By adjusting the RF pulse sequence used to excite the nuclear spins, one can
alter the relative contribution of these three factors and significantly change the
appearance of the image.
Improper RF pulse selection can lead to total loss of contrast at what are termed
as Null Regions.
Thus, the relative contrast between tissues as they appear on the image can be
varies drastically by the RF pulse sequence chosen.
It is important to remember that tissue containing no signal-producing hydrogen nuclei
such as air or cortical bone, will always appear dark in the image.
Furthermore, fat and skin will usually appear bright because they have an
abundance of hydrogen.
The general relationship between the appearance of various tissues and their
relative values of Spin Density, T1 and T2 are as follows:
Note that these relationships are altered with tissue in a diseased state:
Tissues Spin Density T1 T2
Fat & Skin High/White Short/White Long/White
Bone Low/Black Very long/Black Very long/Black
White Matter High/White Short/White Long/Gray
Gray Matter High/White Long/Gray Long/Gray
CSF Very
high/White
Very long/Gray Very long/Black
NMR PARAMETERS:
The MRI signal contains information about not just a single parameter, but about
three independent parameters.
These are Spin Density, T1 & T2.
 SPIN DENSITY
Perhaps the simplest of these parameters to understand is Spin Density (SD).
As one might imagine, the strength of the signal received from the precessing
nuclei is proportional to the number of nuclei within the detection volume of the MR
imager.
That is, if exactly the same experiment is performed on two samples, one of
which has twice the number of hydrogen nuclei as the other, the signal received from
this second sample is twice as large.
In other words, one sample has twice the density of spinning protons as the other
sample, meaning twice the number of detectable spins.
Spin Density therefore is an indication of hydrogen concentration.
 T1 RELAXATION TIME
To understand the other two (2) parameters, T1 & T2, we must take first a closer
look at the details of what happens to the nuclear spins when they absorb energy from
an RF pulse.
When a patient is placed in a strong magnetic field, the passing hydrogen nuclei
attempt to align themselves with this field.
However, thermal agitation prevents alignment of many of the nuclei. The
constant bouncing of one molecule of another knocks some nuclei out of alignment.
As one disturbed nucleus in coming back into alignment, another somewhere
nearby is being bounced out of alignment.
Thus, at room temperatures there is an equilibrium situation, and at any moment some
of the nuclei are aligned and some are misaligned.
 T2 RELAXATION TIME
T2 represents another type of relaxation. This type of relaxation refers to the
second, independent interaction occurring among hydrogen nuclei after excitation by
the RF pulse.
The RF pulse causes the randomly oriented hydrogen nuclear spins to precess in
phase, that is, they become Phase Coherent.
Following a 90 degree RF pulse, the net magnetization is rotating at the Larmor
Frequency in the XY plane.
When the net magnetization is first tipped into the XY plane, the net
magnetization in each part of the tissue is pointed in precisely the same direction,
namely, along the X axis.
All regions of the tissue are said to be in phase. Within the tissue, however,
individual nuclei are continually in motion.
As they pass near each other, their magnetic moments interact, altering their
rate of precession.
With time, the interaction of the slight magnetic field of one spinning nucleus
alters the magnetic field of a neighbor, causing the neighbor to precess slightly faster
or slower.
The nuclear spins rapidly dephase which causes the Magnetic Dipole Moments in
the transverse xy plane (Mxy) to shrink while still precessing at the Larmor frequency.
STANDARD IMAGE SEQUENCE PARAMETERS:
(DEFINITIONS)
 PULSE SEQUENCE
The selection of a particular pulse sequence partly determines the image
sequence parameters and their limitations.
The most common pulse sequences used in MRI today are Spin Echo, Field or
Gradient Echo and Inversion Recovery.
There are several variations or modifications of the pulse sequences, such as
Narrow Bandwidth sequences, 3DFT, STIR and Chemical Shift Imaging.
Once we determine the pulse sequence type needed to yield the desired effect, we
will select image sequence parameters accordingly.
 SPIN ECHO
The sequence that begins with a 90 degrees RF pulse followed by a 180 degree
refocusing pulse to obtain a more usable signal is called Spin Echo.
The echo is the signal from the spins within the tissue that have undergone
perturbation from an RF pulse.
Multi echo spin echo sequences require multiple echoes; one 180 degrees
refocusing pulse for every additional echo required.
 FIELD ECHO or GRADIENT ECHO
Field Echo pulse sequences begin with a flip angle usually less than 90 degrees,
but not always.
Smaller flip angles result in decrease time for longitudinal relaxation to occur,
therefore, TR (Repetition Time) can be reduced.
In addition, instead of a 180 degree refocusing pulse, a gradient reversal
technique is used to obtain the echo.
 INVERSION RECOVERY
In this type of pulse sequence, a 180 degree RF pulse is delivered first so that
the net magnetic vector lies on the longitudinal plane, only in the negative z-axis.
After a period of time, a conventional spin echo RF pulse of 90 degrees is
performed followed by a 180 degrees refocusing pulse.
This portion of the inversion recovery pulse sequence orients the longitudinal
vector in the transverse plane where the usable signal is collected.
 TR (REPETITION TIME
TR (Repetition Time) is the amount of time we wait between successive pulse
sequences applied to the same slice.
It is delineated by initiating the first RF pulse of the sequence then repeating
the same RF pulse at a time.
It is important for its effect on T1 Relaxation Time and the amount of
magnetization vector available for longitudinal relaxation during subsequent RF pulses.
Therefore, it is controlled factor in signal production.
TR is also a factor in total scan time.
 TE or ECHO TIME
TE (Echo Time) is the time from the original RF pulse to the peak of the echo.
It is the time that we receive any returning signal which will be encoded based
on specific tissue characteristics.
The result of T2 dephasing will be evident as T2 contrast and will be identified
using a specific TE.
 FLIP ANGLE
The flip angle used in a pulse sequence will control the amount of vector
component that will be forced by RF into the transverse plane.
The amount of transverse magnetization and therefore the amount of signal
available is maximized using a conventional spin echo pulse sequence.
Any flip angle less than 90 degrees will flip spins into the transverse plane as
well, so the resultant vector and the signal will be less.
TR (Repetition Time) and T1 Relaxation play a paramount role when the selection
of flip angle becomes a necessity as in field or gradient echo imaging.
 TI or INVERSION TIME
TI (Inversion Time) is the interpulse time of the inversion recovery sequence,
greatly influences the contrast of an IR (Inversion Time) pulse sequence.
Specifically, it is the time between the inverting 180 degree RF pulse and the 90
degrees excitation pulse.
The choice of TI is crucial in determining the amount of T1 growth that will occur
during the interpulse time and which will contribute to the resultant signal and
contrast.
TI (inversion time) selection is based on clinical indication.
If fat suppression is desired, a short T1 is chosen (approximately 0.69 of the T1 of fat).
When differentiating between tissues with fairly close T1 relaxation time, such
as white or gray matter, the T1 should be much longer and will result in images with
greater contrast between the Central Nervous System structures.
 SLICE THICKNESS
Slice Thickness is the depth of a three-dimensional volume of imaged area.
It is an important image sequence parameter in MR imaging due to its effect on
signal-to-noise ratio, spatial resolution and partial volume effect.
Signal-to-Noise Ratio (SNR) and Partial Resolution have an inverse relationship, so the
selection of slice thickness becomes a balancing game between maximizing detail over
the region of interest and maintaining SNR.
Slice thickness is chosen according to the anatomy being imaged, clinical
indications and pulse sequence limitations of the hardware and software.
 GAP
Slice selection during the spatial encoding process of MR imaging is accomplished
by generating and RF pulse at the resonant frequency of the slice, as specified by the
Larmor equation.
RF slice profiles on MR systems can be Gaussian profiles, square profiles or any
variant thereof.
Cross contamination between slices can occur with a corresponding decrease in
SNR (signal to noise ratio)
Contamination result of one RF slice profile overlapping another during slice selection
of spatial encoding.
During acquisition, the overlapped areas of the slice have received varying
resonant frequencies, which does not allow for accurate encoding.
A Gap is merely a space between consecutive slices controlled with the offset
frequency of the RF pulses.
This space is often operator selected and is usually a percent of the slice
thickness chosen as specified by the imaging system.
When incorporated into the pulse sequence, cross-contamination can be
decreased of eliminated.
 NUMBER OF ACQUISITION
Number of acquisition, sometimes referred to as Number of Excitation (NEX) or
Averages, is the number of times we collect data per phase encode step and average
the information to produce one image.
As the signal increases linearly, random noise also increases, thus overall
improvement of signal-to noise ratio is only by the square root of the number of
acquisitions.
Scan data acquisitions are also a factor in scan time.
 VOXEL VOLUME
Voxels are three dimensional units having length, width and depth.
MRI acquires tissue information as voxels. Signal is extracted from voxels during
a Fourier Transform and through and elaborate method, converted to a clinically useful
pixel display.
 PIXEL
Pixels are individual units that collectively comprise the length, width of the
matrix.
Individual pixel contribute to the resolving power of our image, referred to as
resolution.
For most MR systems, pixel size is determined automatically by the choice of a
specific matrix and Field of view (FOV).
A relationship between pixel size, FOV and matrix allows indirect selection of
pixel size according to the formula:
FOV = Matrix x Pixel size
Some MR systems allows specific selection of the pixel size as needed to define
a particular region of interest.
The smaller the anatomy, be it normal tissue or pathologic entity, the smaller
the pixel size necessary for edge detail.
 MATRIX
Matrix refers to the number of rows and columns of pixels in our video image.
These dimensions are defined by the number of phase encoding steps, performed
by convention in the y-direction of the matrix and data sampling units or frequency
encoding steps, performed in x-direction.
These intersecting lines collectively comprise the dimensions of the matrix.
From these dimensions, resolving power is define.
 FIELD OF VIEW
Scan Field of View (FOV), is the total dimension of the anatomic region of
interest and is defined by the matrix and the resolution in two dimensions.
Scan FOV is selected to cover a particular tissue volume. The larger the
dimension of the matrix and pixel size, the larger the FOV.
 ECHO TRAIN LENGTH
Echo Train Length (ETL), is a scan parameter specific to newer fast scan
techniques.
It is the total number of echoes collected during one repetition (TR) of one slice
sampled using varying phase encoding steps for each echo.
In conventional spin echo pulse sequencing, only one phase encode step (one
phase gradient variation) per repetition time (TR) per slice is generated.
 ECHO TRAIN SPACING
Echo Train Spacing (ETS) is merely the spacing between each echo in a fast scan
sequence.
For example, ETS in Echo Train Sequence of 25, 50 and 75 milliseconds is 25
milliseconds.
Each Train spacing (ETS) in the Echo Train Sequence of 30, 60 or 90 milliseconds
is 30 milliseconds.
Its importance of associated with its effect on the effective echo time relative
to T1, Proton Density or T2 Weighting, and its effect on blurring of the final image.
 EFFECTIVE ECHO TIME (ETE)
Effective Echo Time is the relative echo time visualized on the final image.
This is achieved by acquiring the signal to the ETE while the phase encode
gradient is at or near zero amplitude.
It is selected according to image contrast requirements based primarily on
clinical indication.
The Effective Echo Time contribute most to the contrast of the resultant image.
INSTRUMENTATION
Similar to CT scan, MRI requires a patient area (magnet room), a computer room
and an operator’s console.
CONSOLE:
The operator’s console is used to control the computer.
The computer then initiates the appropriate radiowave transmission, receive
data and analysis it.
Image then are viewed on the operator’s console to ensure that the proper part
of the patient is being evaluated.
These images maybe photographed usually on radiographic films using a multiimage
camera.
The diagnostic viewing console may perform the same functions as the operator’s
console, depending on system configuration, except that usually only the operator’s
console can control the actual imaging process.
COMPUTER ROOM
The computer room houses the electronics necessary for transmitting the
radiowave pulse sequence and receiving and analysing the MR signal.
The Raw data and the computer-constructed images can be stored on a computer
disk temporarily and are usually transferred to magnetic tape for permanent storage
and retrieval.
Magnet – is the major component of the MR system located in the magnet room.
This magnet must be large enough to surround the patient, and any antenna that
are required for radiowave transmission and reception.
These antennas are frequently wound in the shape of a coil and where patient is placed
within that coil, which coil itself lies within the magnet.
The patient and the coil must be within the magnet to be exposed to the proper
magnetic field for imaging.
Various magnet types and strength may be used to provide the strong uniform
magnetic field required for MR imaging.
1. RESISTIVE MAGNET
Resistive Magnets are similar to superconductive magnets in that they are
typically coils of wire through which a magnetic field is induced. However, the wires
are not cooled to a superconductive state.
Therefore, the wires are resistive, and if a current were applied and power
supply disconnected, the current would eventually die out.
The major difference, therefore, is one of trade-off in operating cost.
A resistive magnet does not require liquefied gases (cryogens), but it does require
a power supply to keep the magnet at a stable field.
As a result of the increasing cost, these magnets are not seen in commercial
systems at strength over 0.4T.
In resistive magnet, magnet field is produced by passing an electric current
through wire coil.
The electrical resistance of the wire produces heat and limits the maximum
magnetic field strength of resistive magnets.
The heat produced as conducted away from the magnet by a cooling system.
2. SUPERCONDUCTIVE (CRYOGENIC) MAGNET
In 1950’s it was discovered that certain types of metal alloy will become perfect
conductor, that is, they will have no resistance to the passage of an electric current
when their temperature is dropped to approximately 10 Kelvin (K) (Kelvin room
temperature is 293K.
At room temperature, these materials behave like other normal conductors, but at very
cold, cryogenic temperatures they become conductors.
They are electromagnets which are the most commonly used magnet. This type
of magnet is notable in that the magnetic field can be maintained for a very long period
of time without requiring a constant source of energy.
This allows the use of this type of magnet in systems that require extremely
strong magnetic fields (above 0.6 Tesla).
A superconductive magnet consists of many windings of wire that carry an electric
current made from a superconducting metal alloy.
The magnetic field generated by this cylinder of wires runs in the direction along
the long axis of the cylinder.
Because of the requirement that the cylinder be wide enough to accommodate
a human for imaging (typically 55 to 70cm in diameter), the magnet is generally very
long in order to provide a uniform field large enough for imaging.
Energy requirement for this type of magnet is great, thus to reduce the energy
required to generate must take advantage of a principle called “superconductivity’.
This phenomenon discovered in 1911 is a state in which the resistance in a conductor
goes to zero at very low temperatures.
The advantage of a superconductive magnet lies in the difficulty of maintaining
the magnet coils at near absolute zero.
The entire coil assembly must be housed inside a giant, highly insulated bottle.
The container has a smooth, shiny exterior and is much like a thermos bottle called a
“Dewar”.
Inside the Dewar are two chambers, where the outer most chamber is filled with
“liquid Nitrogen”, that is, Nitrogen that has been cooled so much that it has condensed
into a liquid.
Liquid Nitrogen has a temperature of 97 Kelvin, which is still not near enough to
absolute zero. The interior container is filled with “Liquid Helium” which exists at 47
Kelvin.
The superconducting coils are suspended in this bath of Liquid Helium.
And separating this cryogenic chamber from each other and from the
environment are vacuum chamber.
3. PERMANENT MAGNET
Are gaining popularity for systems that operate at magnetic fields up to about
0.4T. A large part of this popularity is due to the fact that a permanent magnet has few
requirements to maintain it.
While a superconductive magnet requires cryogens, and a resistive magnet
requires a power supply to maintain its current, a Permanent magnet requires neither.
It has a constant field that does not require additional electricity or cooling to a
very temperature.
Early designs of permanent magnet were extremely heavy, even compared with
the massive superconductive and resistive units, causing difficulties with the
placement/installing in hospitals.
With improvement in technology, permanent magnets may become more
competitive with the other magnet types. - Have the advantage that their magnetic field
does not extend as far away from
the magnet (fringe field) as do the magnetic fields of other types. Fringe field
are a problem because of their effect on nearby electronic equipment.
The disadvantages of using of permanent magnet are its weight and the cost of the magnet
and supporting structures.
In addition, permanent magnets are susceptible to “Hysteresis” (a time varying change in
the field).
• Various MR systems operate at different magnetic field strength. Magnetic field strength
is measured in Tesla or Gauss. Most MR imaging has been performed with field strength
ranging from 0.1 to 1.5 Tesla, although higher strength MR units are under development.
Resistive systems generally do not exceed 0.3 Tesla. Higher field strengths
required superconductive technology.
• The choice of optimum field strength for imaging is controversial. Higher field
strength leads to increase MR signal, which can be used to improve image
sharpness or to obtain the image data faster. Although some authorities argue
that higher field strength leads to reduce tissue contrast.
• Regardless of magnet type, MR imaging units are relatively difficult to locate in
a hospital. Current units are quite heavy, up to 10 tons for resistive and
superconductive magnets and approximately 100 tons for some permanent
magnets.
With resistive and superconductive magnets, the fringe field extends in all directions. These
fringe fields may interfere with nearby electronic or computer equipment such as television
monitors and computer tapes. In addition, metal moving through the magnetic fringe field,
such
as automobile or elevators, may cause ripples in the field, similar to the ripples occurring
when a
pebble is thrown into a pond. This ripples can be carried into the center of the magnet
where
they distort the field and ruin the image.
Thus, MR sites must be located far enough away from such moving metal objects to
prevent this problem. Shielding of the magnetic fringe field to prevent its extension
beyond the patient area continues to be developed to solve this difficulty.
* The radiowaves used in MR imaging may be the same as those used for other nearby
radio applications. These stray radio waves from outside sources could be picked up by
the MR antenna coils and interfere with normal image production.
Many MR facilities require special room construction to shield the antenna from
outside radio interference, which adds to the cost of the installation.
BIOLOGIC HAZARDS
Although we have very little information regarding the biologic response of
humans to the fields of MRI, there is a large volume of research literature concerning
the biologic responses to magnetic fields and to radio frequencies combined
individually. It can be said with reasonable certainty at this time that there are no
harmful effects from MRI.
Research investigations on laboratory animals, chromosomes, plant seeds and
molecular species have shown that biologic responses can be produced following
extremely high intensities of MRI fields. In each case, the dose-response relationship
is threshold in nature.
Three physical fields are associated with MRI that one might suspect of producing
a biologic response. These are the strong magnetic field (Bo), the time-varying gradient
magnetic field (B1), and the RF emission.
In x-ray physics, the dose of the physical agent is measured in rad (gray (Gy).
Since the radiation dose involved in MRI is non-ionizing, different types of dose
specification are used. The static magnetic field strength is measured in Tesla (T) or
Gauss (G), Varying magnetic field is in Tesla per second (T/s), and radiofrequencies (RF)
in Watts per kilogram (W/kg).
BIOMEDICAL EFFECTS OF MRI
At the current levels of magnetic field strength and radio wave energy
transmission, there are no known hazard intrinsic to patients exposure to MR imaging.
However, the magnetic field itself is potentially hazardous to certain patients who have
artificial metallic or electronic devices within them. For example, cardiac pacemakers
may be adversely affected by the strong magnetic fields. Aneurysmal clips on blood
vessels within the skull could be twisted by the magnetic field and vessels could be
torn. Therefore, caution must be used in allowing patients or visitors to enter the
magnet room.
Although MRI is biologically safe, certain precaution must be taken near the
magnet.
Personnel must remember that the magnetic fields involved are strong and are
capable of exerting significant forces on magnetic materials such as utensils made out
of iron or steel. Care must be exercised with small miscellaneous objects such as pins
and paper clips, since they may be easily sucked into the magnet.
Special care is necessary when using larger objects such as wrenches,
screwdrivers and other hand tools.
When such objects are brought near the magnet, the magnetic field is strong
enough to pull these from your grasp with sufficient force to cause either injury to
yourself, or other personnel, or the patient or damage to the imager.
MRI magnetic fields are also strong enough to affect such other personal items
as bank cards and mechanical watches. Many credit cards contain magnetic strips
encoded with identification information. Carrying such cards near the magnetic field
can scramble the magnetically coded information and invalidate the card.
EXAMINATION PROTOCOLS:
INSTRUMENT PARAMETERS:
The ability of many adjustable parameters makes MR a complex imaging
techniques.
Knowledge of the patient’s clinical condition or the probable disease is important
in choosing the proper technique and imaging the correct area of the body.
A choice must be made whether to obtain a single slice image through a specific
position in the body or to obtain multiple slices.
Large area can be covered by making a series of single slice just like CT.
However, each MR slice requires considerable time to acquire, usually 2 to 5 minutes,
compared with less than 1 minute for a CT slice.
The operator may choose to obtain MR images in the Sagittal, Coronal or
Transverse planes. These are independently acquired images with equal resolution in
any plane.
Slice Thickness is important in the visualization of pathology. More MR signal is
available from a thicker slice that a thinner slice so that thicker slices may provide
more pleasing images that are less grainy. However, small pathologic lesions may be
hidden by the surrounding tissues in the thinner slices. Therefore slice thickness may
be adjusted depending on the type of lesion under investigation.
Another important parameter is the over-all imaging time. As imaging time (per
slice) is lengthened, more MR signal is available for analysis. Imaging quality thus
improve with increase signal. In addition, patient motion increases with prolonged
imaging time, reducing image quality.
The radio wave pulse sequence is a crucial parameter in MR imaging. Depending
on the choice of pulse sequence, the resulting images may be more strongly weighted
toward Proton Density, T1 or T2 information. A pathologic lesion may be easily
recognized or difficult to see depending on the relative emphasis given to these factors.
MRI SAFETY CONCERNS
 Static Magnetic Field
Although it cannot be seen or felt directly, the magnetic field of the MR system
must be respected. The field will generate a force that acts on ferromagnetic objects,
drawing them into the magnet. The field can also affect the operation of magnetically
sensitive devices, such as pacemakers. It can erase the data from magnetic plates and
cards (such as credit cards).
OBJECTS CONTAINING FERROMAGNETIC MATERIALS REPORTED AS HAVING BEEN
INADVERTENTLY EXPOSED TO AN MRI MAGNETIC FIELD:
Metal fan Hearing aid Chest Tube stand
Tile cutter Jewelry Bucket
Buffling machine Scissors MR Table parts
Pulse Oximeter Mop Magnet
Shrapnel Film Magazine Pen, Paper clips
Wheelchair Steel tipped Clipper
Knife Tile roller Gurney
Cigarette Lighter Calculator Tools
Stethoscope Hairpin Clipboard
Pager Oxygen tank Key Watch
Pacemaker’s Prosthetic limb
 Movement of Implanted Devices
An important consideration is that ferromagnetic objects brought into the
influence of the magnetic field maybe inside the patient as well as externally
noticeable objects.
Care should be taken to avoid deflection or movement of these objects as a result
of the static field.
Surgically implanted clips, such as aneurysm clips maybe ferromagnetic; these
must not be introduce into the field, and any patient with such implanted objects
should be excluded from imaging.
It is crucial therefore, to screen patients before imaging them. This screening
should include a verbal examination of the patient, as well as checking any other images
that might show implanted objects. If indicated, the patient’s referring physician
should be consulted to ensure the patient safety.
 Magnetic Field Affecting Magnetically Sensitive Device
Devices that are not ferromagnetic may still be affected by proximity to a
magnetic field. The function of cardiac pacemakers, for example, may be affected by
magnetic fields as low as 17G. Patient with these devices should be excluded from
imaging.
IMAGING COIL TECHNOLOGY
MR is based on the interaction of magnetic fields and radiowaves. The MR signal
is produced when the tissue magnetization moves through an antenna oriented in the
transverse XY plane. The current produced in the antenna is used to create the final
image. The RF coils are the Antenna.
In MRI, the sample of tissue being examined is the signal generator. The
transverse magnetization vector rotates in the XY planes rather than oscillating in a
linear orientation. When this magnetic vector rotates through our receiver coil, the
electrons in the conductor move and produce a current in the receiver coil.
This is known as Faraday’s Law of Induction. When a magnetic field moves
through a loop of wire, a current is produced in that wire. The strength of the current
is related to the conductivity of the wire, and the strength of the magnetic field.
The stronger the magnetization vector, the greater the amplitude of the
resultant signal. Because the rotating magnet field passes in and out of the plane with
our receiver coil, the signal in the coil oscillates at the frequency of the magnetic field
precession.
VARIOUS CONFIGURATION OF COILS AND THEIR APPLICATIONS: 1. TRANSMIT and RECEIVE
COILS
Most MR systems have two main types of imaging coils; Receive only and Transmit
& Receive (T/R). The two most common coils to be configured as Transmit & Receive
are the Body coil and the Head coil.
Coils used for extremity imaging can be either, depending on the manufacturer’s
reference.
Typically, Transmit & Receive coils are felt to be more efficient than receive only
coil.
The close a coil is to the area or part to be excited, the less RF energy is needed to
create transverse magnetization. This directly reduces the Specific Absorption Rate
(SAR) to the patient. In addition, having a receive coil close to the excited volume will
detect a larger signal, hence improving the signal-to-noise ratio (SNR).
Several types of smaller coils may be configured as T/R coils. They are typically
used for imaging the head and/or extremities.
In a vertical field system where the XY plane is along the axis of the patient’s
body, the basic design of the coil is a Solenoid (a helix coil, with an electricity following
through the conductor) or a Wraparound configuration.
Larger body coils maybe within the magnet enclosure or they may be outside the
enclosure but around the patient like a large clamshell.
2. RECEIVE ONLY COIL
Coils that only receive MR signal are called Receive only coil. These coils may
come in variety of shapes, configurations and sizes. Coils that were designed to be
placed around or on a specific area are called Surface Coils.
Some are designed to be placed internally within the body, such as the Endorectal
coil used to image the Prostate. There are now three different configurations of this
particular coil. Each one is specifically designed to image the prostate, rectum or
uterus.
Surface coils and other small body part specific coils are now often referred to
as Local Coils. It is the beginning to be a standard practice to use some types of local
coil specific to whatever area of the body we are imaging.
SURFACE COILS:
One of the big battles in MRI is to produce images with high Sound-to-Noise ratio
(SNR). Noise can be defined as “unwanted signal”. The advent of surface coil imaging
was a big help the battle.
A Surface Coil is a receiving antenna which can be placed close to the source of
our signal.
Surface coils can help improve our SNR by listening to a more limited area than
a larger coil, such as the body coil, thereby reducing signal we don’t want or need. In
other words, surface coils increase signal.
Getting an antenna close to the source of MR signal enables more efficient
reception of the MR signal.
The major advantage of using a surface coil is related to this increase in SNR.
Just as a coil transmitting radio-frequency has a certain distance over which it
radiates its signal, a receiver coil has a certain area of sensitivity over which it receives
signal.
The area of sensitivity is related to the diameter of the coil. As a general rule,
increasing the size of the coil will increase the area of coverage and decrease the SNR.
GENERAL RULES FOR SURFACE COIL USE: 1. Match the coil to the anatomy or the area you
desire to image. There is no need
to use a coil larger than the area of interest because of the negative impact on
SNR. 2. Match the field of view (FOV) to the size of the coil. If this is done, the resolution
can be optimized and the need for anti-aliasing techniques can be eliminated.
OTHER COIL CONFIGURATIONS
A. Helmholtz Coil can be described as two coils working in tandem used for imaging the
anterior
neck and/or the cervical spine.
This sometimes referred to as a Volume Coil. This differs from the quadrature coil in that
it is actually two linear coils. The purpose is to improve the signal through a volume of
tissue.
B. Phased Array or Multicoil. In this type, each coil in the array is wired to its own receiver
board
or channel. In this type of configuration, each single coil does not see any other coil in the
array.
Usually if two coils are placed close together, they will interact with each other
reducing the over-all SNR of the image because each coil detects noise from the other.
With Phased Array Coils, each coil is independent of the other, each has its own separate
receiver channel.
SECONDARY COILS: 1. Shim Coil
Inside the aperture of the main magnet is positioned a drum with up to 30
individual windings called the Shim coils, each with its own power supply.
After the magnet has been brought up to field, the current and polarity of each shim
coil will be adjusted to produce maximum homogeneity (uniform) in external magnet
2. Gradient Coils
Are three paired orthogonal coils located within the gantry which collectively
and sequentially generate their magnetic field into “Static Magnetic Field, for the prime
purpose of selective spatial excitation. Gradients are also used for reversal pulses in
fast scanning pulsing techniques.
To obtain spatial information about the tissue from which the MRI signal is
emitted, it is necessary that the primary magnetic field be slightly varied by using a
“Gradient Magnetic Field”.
The Gradient Magnetic Field is produced by electric coils called “Gradient coils”.
To obtain projections from a variety of directions, we must be able to orient the
gradient field along either the X, Y, or Z axes, or along any oblique plane.
Normally, the Z-Gradient coils are used for selection of a Transaxial slice.
When the Z-Gradient magnetic field is ON, the RF pulse can be precisely tuned so that
only the hydrogen nuclei in a given slice of the patient are energized.
The strength of the gradient magnetic field and the shape of the RF pulse
determine the width of the slice selected.
If a Coronal slice is desired, the X-Gradient coil will be energized. Energizing
the Y-Gradient coil will produce a Sagittal slice, and energizing all three pairs of coils
simultaneously will result is an oblique slice.
For a two-dimensional Fourier Transformation (2DFT) imaging of Transaxial
anatomy, the Z-gradient is ON during the excitation RF pulse to select the appropriate
slice.
While receiving the MR signals, the X and Y gradient coils will be sequenced on.
The X-gradient conventionally is termed the “Frequency-encoding Gradient”, and the
Y gradient, the Phase-encoding Gradient”.
The MRI system contains no moving parts and can produce not only transverse
images but also sagittal, coronal, and any oblique image of the volume of tissue lying
within the gradient coils.
FACILITY DESIGN:
Because MRI involves no ionizing radiation, it is not necessary to shield the room
with any other x-ray attenuating material such as lead.
Depending on the design of the imager and the location of the room, it may be
necessary to have the room shielded against radio interference and fringe field.
Great care must also be taken to ensure that only non-magnetic materials are
used for the structure and finish of the examination room.
Polyvinyl Chloride (PVC) reinforcing rods should be substituted for iron
reinforcing bars in any structural concrete slab or walls.
All electrical penetrations into the room must have an electric filters to remove
interfering frequencies. Plumbing should not be iron bur PVC or copper. And the
lighting should be a direct current.
ELECTROMAGNETIC SHIELDING
The range of radio frequencies used in MRI imaging is very crowded with
commercial and amateur radio broadcast and other interference generated by power
transmission and electronic system.
This RF interference can easily be strong enough to mask the faint MRI signals
from the patient.
A carefully constructed wire-mesh shield enclosing the MR imager is necessary to
attenuate these extraneous sources of RF.
Such a shield is called a “Faraday cage or an RF shield. This shielding, like x-ray
lead shielding, need not be visible but can be covered by gypsum board or wood
paneling.
It is important to remember that this shielding exists solely to screen outside
sources of RF interference. No radiation shielding is required either as a primary or
secondary barrier for the protection of personnel, patients, or the general population
as in x-ray imaging.
Indeed, it is completely safe for attending personnel such as Technologists and
Radiologists to remain in the room with the patient when necessary.
Magnetic Shielding:
The magnetic field outside of the patient aperture is called a Fringe Magnetic
Field and must be considered in the design of an MRI facility. This is especially
important if the facility is to house a superconducting magnet with high field strength.
The problem with the fringe field is two folds.
First, it can interfere with the proper operation of mechanical and electronic
equipment. Electronic equipment is most sensitive. Any device such a CRT, image
intensifier tube, or photomultiplier tube that operates on the principle of electron flow
in a vacuum can be affected.
The fringe magnetic field will cause the electron flow to be diverted. Electron
microscopes are most easily influenced.
Second, any large mass of ferromagnetic material, especially moving masses,
can distort the homogeneity (uniformity) of the imaging volume by interacting with the
fringe magnetic field.
A distortion of the fringe magnetic field results in a compensating distortion in
the imaging volume and degrade or destroys the image.
MR CONTRAST MEDIA
Contrast agents are pharmaceuticals which increase the information content of
diagnostic images.
Image Contrast is the difference in signal intensity between two tissues, and
Contrast Enhancement is the process of altering this difference.
The term Enhancement is also generally applied to any pharmaceutically based
manipulation of tissue as manifested on a diagnostic image.
Image Contrast may be enhanced by increasing or decreasing the signal intensity
of one tissue relative to another.
Image Contrast may be altered by manipulation of the physical parameters
inherent to the imaging method, or through the administration of a pharmaceutical to
alter the physical characteristic of tissue itself.
The recognition of the importance of magnetic materials and their effect on the
Relaxation time of resonating protons occurred almost simultaneously with the
discovery of the Magnetic Resonance process in 1946.
Paul Lauterbur was not only responsible for the seminal development of the
Magnetic Resonance technique, but also the conception and subsequent development
of contrast enhancing media.
In 1978, he published the first use of Paramagnetic ions and Chelate complexes
to alter relaxation times in canine tissues.
During the early years of MRI, the need for a contrast enhancing medium was
strongly debated. Initially, one of the primary reasons for adopting MRI over alternate
imaging modalities was its non-invasive nature, combine with the exceptional quality
of unenhanced T1 and T2 weighted images compared with those obtained from
comparable modalities.
Contrast agents that widen the signal difference in MR images between various
normal and abnormal structures are a continuing area of research and development.
The perfect agent for oral administration to identify bowel loops in MR scans has not
yet been identified.
In CT scanning, high-attenuation oral agents clearly differentiates bowel from
surrounding lower attenuation structures.
The only intra-venous MR contrast agent approved in the U.S. for routine clinical
use is “Gadolinium-Diethylene Triamine Penta Acetic Acid” (DTPA) which is metal and
with paramagnetic effects.
Pharmacologically, Gadolinium-DTPA acts very much like radiographic Iodinated
I.V. agents, wherein it distributes through the vascular system, and its major route of
excretion is the urine.
The development of Gadolinium-DTPA Dimeglumine or Gadopentetate
Dimeglumine, commenced around 1981 and its first reported use in humans occurred in
1984.
It was soon recognized that additional enhancement of image contrast between
normal and diseased tissue could increase the sensitivity and specificity of MR diagnosis.
MR contrast enhancement offered the hope of identifying smaller lesions earlier
in the progression of disease, discriminating tumor mass from edema and recurrent
tumor from fibrous tissue.
It has lower toxicity and fewer side effects than the I.V. Iodinated contrast media
used in radiography and Computerized Tomography.
The most important clinical action of Gadolinium compounds is to shorten T1,
and is used most frequently in evaluation of the Central Nervous System.
In addition, Gadolinium-enhance T1 weighted images are better at separating
“brain tumors” or “metastasis” from their surrounding edema than routine T2 weighted
images.
Gadolinium also improves the visualization of “small tumors”, or tumors that
have signal intensity similar to normal brain, such as Meningioma.
GATING:
Gating is a technique of organizing the data, so that the information used to
construct the image comes from the same point in the cycle of a repeating motion such
as “heartbeat”. The moving object is “frozen” at the phase of its motion, thereby
reducing image blurring.
Gated images are another technique for improving image quality in areas of the
body where involuntary patient motion is a problem.
During the procedure, we know that patient can hold his head still for a
prolonged data acquisition, but he cannot stop his heartbeat nor can he stop breathing
for the several minutes required to obtain an image.
This patient motion is a problem when images of the chest or upper abdomen
are desired. And if this technique are not employed, part of the MR signal maybe
obtained when the heart is contracted (systolic phase), and part when the heart is
relaxed (diastolic phase).
Now, if this information (the contraction and relaxation phases) is combined into
one image, the image of the heart will be blurred.
To solve this problem, Gating techniques organize the signal so that only the
signal received during a specific part of the cardiac or respiratory cycle is used for
image production.
POSITIONING:
 Patient positioning is usually straight-forward with MR units. In general, the
patient lies supine on a table that is subsequently advanced into the magnetic
field.
 It is important to check that the patient has no contra-indications to MR imaging
such as Cardiac Pacemakers or Intra-cranial Aneurysmal clips.
 Occasionally patient positions other than the supine position are employed. For
example, the patient may be turned partly to the side to obtain oblique images.
 Prone or Decubitus positioning also may be used to shift structures under the influence
of gravity or for patient comfort.
 Sometimes Claustrophobia may be a problem for some patients because of the
tunnelshaped of most MR systems.
Claustrophobia – an abnormal fear of enclosed or narrow places. It is a psychological
reaction to
being confined to a relatively small area.
Example, gantry, tunnel etc.
CLINICAL APPLICATION
A. CENTRAL NERVOUS SYSTEM
MR imaging is superior to CT in imaging of the Posterior Fossa, the portion of the
brain that includes the cerebellum and Brain stem. Artifacts from the dense bone of
the surrounding skull obscure this area with CT. There is very little MR signal from bone
so that this area is artifact-free with MR imaging.
In general, the absence of bone artifact with MR is a distinct advantage over CT.
However, the inability to image calcified structures can be a disadvantage when the
lesion is more easily recognized because of its calcium content.
Lesions such as calcified granuloma of the lungs or calcification in certain tumors are
more difficult to detect with MR than in CT.
MR is playing an increasing role in the routine examination of the brain and
because there is natural contrast among tissues with MR than in CT, the differentiation
of gray matter from white matter in the brain is better with MR. This enables MR to be
more sensitive than CT in detecting white matter disease, such as multiple sclerosis.
Also, primary and metastatic brain tumors, pituitary tumors and acoustic
neuromas are generally better demonstrated by MR than CT.
 MR also can detect cerebral infarction earlier than can CT, but both test can
provide similar information in sub-acute and chronic strokes.
 The absence of bone artifacts allows excellent visualization of the contents of
the neural canal that is why; MR has been successfully used to image the spinal
cord.
 In addition, the technique can separate the spinal cord from the surrounding
Cerebro-spinal fluid (CSF) without the necessity of contrast agents injected
directly into the CSF, as in CT Myelography.
 MR is sensitive in the detection of spinal cord tumors and cystic changes of the
spine, and is also valuable in the detection of Degenerated (deteriorated) and
herniated spinal disk.
B. CHEST
The chest would seem to be an ideal area for MR examination. The lung have low signal
as a result of low proton density, and the flowing blood in the great vessels of the chest also
have
a low MR signal.
The heart muscle is well outlined by the lung and moving blood within the chambers.
Furthermore, examination of the mediastinum is potentially fruitful since the normal
structures
of blood vessels and airways are of low signal.
So, any tumors of the mediastinum would be easily seen as areas of MR signal standing
out against the normal low signal surrounding.
The ability of MR to image in multiple planes (transverse, sagittal, coronal, etc.)
may be helpful in evaluating tumor spread in the thoracic inlet, chest wall or brachial
plexus region.
Though difficulties with chest imaging remain because of cardiac and respiratory
motion, this being made possible by applying Cardiac Gating and Respiratory Gating.
C. ABDOMEN
Respiratory and Cardiac motion also detract from upper abdominal images.
Again, Gating should be of assistance.
There is evidence the MRI is more sensitive in detecting primary and metastatic tumors
of the liver.
The Supra-renal (adrenal), kidneys and retro-peritoneal structures such as lymph
nodes are very well seen in MRI.
Also, MR has some ability to predict the histologic diagnosis of certain
abnormalities. For example, Hepatic Hemangioma- common benign tumors of the liver
have a distinctive MR appearance that can be helpful in ruling out other causes of
Hepatic masses.
D. PELVIS
The ability of MR to image in the coronal and sagittal planes is helpful in
examining the curved surfaces in the pelvis. For example, bladder tumors are well
shown, including those at the dome and the base of the bladder that can be difficult to
evaluate in the transverse dimension.
In the prostate and female genital tract, MR is useful in detecting neoplasm and
its spread.
E. LIMBS
MR produces excellent images of the limbs because they are free of involuntary
motion, and there is excellent MR contrast among the soft tissues.
Also, the lack of bone artifact on MR permit excellent visualization of bone
marrow.
Over-all, the ability to image in multiple planes along with excellent visualization
of the soft tissues and bone marrow, has led to a rapidly expanding role for MR in
Musculo-Skeletal imaging.
MR IN MUSCULO-SKELETAL IMAGING IS VALUABLE IN; 1. Studying joints and is replacing
Arthrography 2. To a lesser excellent, Arthroscopy, in evaluating of the injured knees. 3.
Local staging of soft tissue and bone tumors 4. Early detection of Ischemic Necrosis of bone
5. Early detection of Legg-Calves Perthes Disease
F. VESSELS
The contrast between soft tissue structures and the typical low signal of flowing blood,
gives MR the ability to visualized Thrombosis within or tumor invasion of the major vessels,
such
as vena cava.
Also, vascular anomalies dissections can be well evaluated by MR.
Special Pulse Sequence under development allow MR visualization of moving blood
within the vascular system, and may permit non-invasive Angiogram-like images of the
vessels.
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